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Statistical Process Control SPC
Statistical Process Control SPC
The inherent strength of these charts is that they provide a visual representation of the
performance of a process by establishing data comparisons against calculated limits (known as
the upper and lower control limits). These limits, which are a function of the data, give an
indication via signals or chart interpretation rules as to whether the process exhibits either
common cause or special cause variation. The charts also visually demonstrate the inherent
width or spread of the variation being generated within any given process.
In simple terms, improvement efforts would first seek to remove special cause variation in order to
create a stable and in control process. This would be followed by efforts to reduce the spread (or
width) of the common cause variation. Processes that are in control provide natural process limits
that can be compared to specifications, targets or standards with corrective action being taken as
required. Comparisons between specification limits and process performance enables the
calculation of system capability i.e. the ability of the process to meet customer and business
requirements. Information of this type is fundamental in guiding process improvement strategies.
Variation
There are therefore two types of variation found within SPC charts as mentioned above:
Natural (common cause) variation
Are more sensitive than run charts a run chart cannot detect special causes due to
point to point variation or use rules for detecting special causes.
Have the added feature of control limits which estimate natural variation.
Define process capability.
Allow us to more accurately predict process behavior.
To identify if a process is sustainable - i.e. are your improvements sustaining over time?
To identify when an implemented improvement has changed a process - i.e. it has not
just occurred by chance.
To understand that variation is normal and to help reduce it.
To generally understand processes - helping make better predictions and thus improve
decision making.
To recognise abnormalities within processes.
To prove or disprove assumptions and (mis) conceptions about services.
To drive improvement used to test the stability of a process prior to redesign work,
such as demand and capacity.
Further practical applications of SPC charts include the ability to calculate a recommended
capacity based on demand by using the charts to plot daily demand over time.
Solve your process issues you will need background intelligence in order to
understand the process for potential redesign.
Provide all the answers SPC analysis is a tool to complement all other methodologies
i.e. process mapping.
Validate data SPC is only as valid and reliable as the data used to create the charts.
By examining the fairly typical data chart on the previous page (but particularly the data for
hospital B and hospital J), our eyes are naturally drawn to the biggest and smallest numbers it
is often these numbers that can inadvertently influence ones decision making process.
However, if we were to plot hospital B data using an SPC chart (see below), we would see that the
high and low numbers are in fact special cause variation that is to say not part of the natural or
normal process. It would therefore be ill-advised to make decisions on ad-hoc data that was not
part of the normal process as by doing so can fuel further variation within the process. Equally, the
individual data point may have been input incorrectly.
*The bias correction factor, d2 is a constant for given subgroups of size n (n = 2, d2 = 1.128)
What do I do next?
Once you have a chart, you will need to understand what it means in order to determine your next
course of action. Initially you will be looking to see if a chart contains special cause variation or
natural variation is the process in control or out of control? You need to remember that a process
containing special cause variation is unpredictable and the data should not be used to reliably
calculate a processes capability.
Determining the type of variation contained within a process is crucial at this stage (see chart on
previous page) as your intervention could lead to increased variation or wasted resources if you
take the wrong course of action. This is why it is sometimes better to use SPC to determine the
type of variation contained within a process before any service improvement work is carried out i.e.
prior to demand and capacity.
You should then develop improvement strategies - improvement strategies are determined by the
sources of variation.
Special cause variation investigate and find out why it exists and what each special
cause data point may mean - remember that not every special cause is a negative factor
as by redesigning the process, you are inadvertently introducing special cause variation.
Natural (common cause) variation change the process if you want to improve Reduce the amount of variation by redesigning the process.
The control limits will give you a reliable indication in terms of the overall variation within the
process. For example, the chart on the right represents a call to needle process where individual
patient call to needle times have been plotted chronologically over time. While the average time is
50.64 minutes, the variation is between 0 and 106.93 minutes. This would indicate that any patient
entering this process could expect to wait between 0 and 107 minutes to receive thrombolysis
treatment from their point of call. Special cause variation points have also been flagged which
would require further investigation in order to understand this process.
There are different rules applied in determining special cause variation found within SPC charts
some software automatically highlights these for you, such as Rapport, but you can find more
details about these rules by using the link to further resources within this section.
You then continue to use SPC charts to see if there has been an improvement in the process.
Ideally, as this occurs over time, you will see the overall natural variation reducing and the process
capability increasing. SPC charts should not be considered as a one-off methodology but used
continually to monitor process performance.
Process capability
A capable process is able to produce products or services that conform to specifications. SPC
charts can also enable you to see if a particular process can meet a specific target. The calculation
used will determine the process capability. Most software currently available to generate SPC
charts will not calculate the process capability so this will have to be done manually. However,
Rapport will calculate this for you.
The calculation used to determine process capability is: Capability = Target - Average divided by 3
times standard deviation
A value of 1 means the process is 100% capable of achieving the target. A negative figure means
more than 50% of patients will not meet a given target.
The procedure for calculating process capability is therefore:
If unstable, gain control by identifying and controlling the main factors that affect the
situation.
Only if it is stable and in control, calculate a process capability to determine if it is
capable of meeting the target.